title: Randomised clinical trial: Helicobacter pylori eradication is associated with a significantly increased body mass index in a placebo-controlled study.
abstract: BACKGROUND
  Body mass index (BMI) increased following Helicobacter pylori eradication in several Japanese cohorts, which requires further investigation.
  
  
  OBJECTIVE
  To determine the impact of H. pylori eradication on BMI in a European population.
  
  
  METHODS
  A total of 10,537 unselected people aged 20-59 years were screened for H. pylori; 1558 of the 1634 infected participants were randomised to intervention (eradication therapy: ranitidine bismuth citrate 400 mg and clarithromycin 500 mg twice daily) or placebo for 2 weeks with follow-up at 6 months (92%) for weight and dyspepsia symptoms (epigastric pain).
  
  
  RESULTS
  The mean weight of participants in the intervention group increased from 77.7 kg at baseline to 78.4 kg at 6 months (unadjusted increase of 0.7 kg) and from 76.8 to 77.2 kg (0.5 kg) in the placebo group. The adjusted difference between randomised groups was statistically significant at 0.6 kg [95% confidence interval (CI) 0.31, 0.88]. Significantly, more participants gained ≥3 kg in the intervention group (138/720, 19%) compared with the placebo group (92/706, 13%) [odds ratio (OR) 1.57 (95% CI: 1.17, 2.12)]. The mean BMI increased from 27.5 to 27.8 kg/m(2) at 6 months in the intervention group compared with the increase from 27.0 to 27.2 kg/m(2) in the placebo group [adjusted difference between groups was statistically significant at 0.2 kg/m(2) (95% CI: 0.11, 0.31)]. Dyspepsia was less frequently reported by intervention group participants (168/736, 23%, placebo group 209/711, 29%), OR 0.71 (95% CI: 0.55, 0.93).
  
  
  CONCLUSIONS
  Body mass index increased significantly following randomisation to H. pylori eradication therapy, possibly due to resolution of dyspepsia.
authors.affiliation: School of Social and Community Medicine, University of Bristol, 39 Whatley Road, Bristol, UK. athene.lane@bristol.ac.uk
authors.forename: J A
authors.initials: JA
authors.lastname: Lane
authors.forename: L J
authors.initials: LJ
authors.lastname: Murray
authors.forename: I M
authors.initials: IM
authors.lastname: Harvey
authors.forename: J L
authors.initials: JL
authors.lastname: Donovan
authors.forename: P
authors.initials: P
authors.lastname: Nair
authors.forename: R F
authors.initials: RF
authors.lastname: Harvey
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D017291:Clarithromycin / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D004415:Dyspepsia / Q000188:drug therapy*; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage*; D010919:Placebos; D011899:Ranitidine / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D009942:Organometallic Compounds; D010919:Placebos; D011899:Ranitidine; D017291:Clarithromycin; C002791:bismuth tripotassium dicitrate